A federal appeals court has revived the U.S. military’s longstanding prohibition on allowing people with HIV to enlist, ruling that the policy remains within the bounds of military discretion despite advances in treatment.
In a unanimous decision issued Wednesday, a three-judge panel of the Richmond-based U.S. Court of Appeals for the Fourth Circuit concluded that the armed forces may lawfully bar HIV-positive applicants from joining. The court reversed a 2024 decision by a federal judge in Virginia who had struck down the enlistment ban, calling it outdated and unsupported by modern science.
Court Defers to Military Judgment
Writing for the panel, Circuit Judge Paul Niemeyer said the judiciary must give substantial deference to the military’s assessments about readiness and operational needs. He was joined by Judges Allison Rushing and Julius Richardson.
The opinion emphasized potential costs and logistical concerns. According to the court, treatment for HIV can reach up to $20,000 annually per service member. The panel also cited possible complications tied to overseas deployments, including access to medication and diplomatic sensitivities in certain host nations.
“All of the considerations advanced by the Military are reasonable military judgments related to its legitimate mission,” Niemeyer wrote, concluding that the policy bears a rational connection to national defense objectives.
The ban was first formalized in 1991 and has since been adopted through regulations across every branch of the armed forces.
Plaintiffs Point to Medical Advances
The case was brought by three individuals living with HIV who sought to enlist. They are asymptomatic and maintain undetectable viral loads through medication. According to the U.S. Centers for Disease Control and Prevention, up to 95% of people receiving consistent treatment can achieve an undetectable status, meaning the virus cannot be transmitted sexually.
Attorneys for the plaintiffs argued that people with undetectable viral loads can meet fitness standards and deploy worldwide without posing risk to others. They contended the enlistment prohibition violates constitutional due process protections.
Gregory Nevins of Lambda Legal criticized the ruling, saying it dismisses decades of scientific progress and overlooks the record of HIV-positive Americans who have served capably in uniform.
The U.S. Department of Defense did not immediately comment on the decision.
A Different Outcome Than Past Rulings
This latest decision stands in contrast to a separate 2020 case in which another Fourth Circuit panel blocked the Pentagon from discharging or restricting deployment of current service members living with HIV. The court distinguished Wednesday’s case on the grounds that it involves civilians seeking entry, not active-duty personnel.
In 2024, U.S. District Judge Leonie Brinkema in Alexandria had ruled that the enlistment ban undermined recruitment goals and reinforced stigma. The appeals panel disagreed, concluding that even if policy debates persist, courts are not positioned to override military determinations absent clear constitutional violations.
The case is Wilkins v. Hegseth, No. 24-2079.
As debate continues over the intersection of public health and national security, the ruling underscores how much latitude federal courts are willing to grant the armed forces, even as medical science evolves.
